THE JOHNS HOPKINS MEDICAL INSTITUTIONSPancreas Cancer Web

KEN

My husband, Ken, was 67 when he was diagnosed August 31, 2000 with Stage IV
pancreatic cancer. He had been hurting just below the rib cage since March.
At first the Dr.'s said that it was indigestion, then when his older brother
was diagnosed with colon cancer, he scheduled a colonoscophy and broncoscope.
The colon was clear, except some polyps that were benign, and nothing showed
in the stomach except a small ulcer. The diagnosis then became ulcers were
causing his pain. He went on medication for the ulcers for two months. All
this time he was in pain. He was havinng problems with constipation and
feeling like he was going to throw up every time he ate. He therefore cut
down on his portions and began losing weight. Not a lot at first. Just 5 to
10 lbs. The pain got so bad, I insisted he go back to the Dr., and they
scheduled a Ct scan. It showed a "mass" in his abdomen. He was
admitted to the hospital that afternoon (Thursday). They began pain
medication, and he was able to get relief. Due to the holidays (over labor
day), nothing else was done until the following Tuesday. The fine needle
biopsy results did not come in until Friday. He asked to wait until after
our 40th anniversary before having the single bypass done, so the surgery was
scheduled for the 25th of September and we went home for 2 weeks. I took him
to FL to see his brother and he was able to go through some of his things and
give his children things he wanted them to have. The surgery was to take 4
hours, but was over in just 1.5 hours. The surgeon told me "it is a
mess in there". The veins in his abdomen were all distended from the
cancer and there was a minimal amount of work he could do. He inserted a
G-tube in his intestines so he could receive nourishment and told me that it
would be about 2 weeks before his intestines began to work and he could use
his stomach. The internal swelling had to go down. He was in intensive care
for 2 days and on the high observation floor for 6 days. During that time he
was convinced at several points that the nurses were trying to kill him.
They told me it was delusions from the morphine. Finally he was able to be
moved to a surgical floor and started being able to walk. He tried so hard.
He had a gastro tube, IV's, continuous tube feeding, and a catherer. Just
getting up was a production. I tried to bolster him in the bed with pillows
to ease the pressure points and keep his heels and elbows from getting sore.
He would try to eat, then throw up. Could never keep anything down.
Finally, they took him down for another bronchoscope to see why he was unable
to eat. They found that the "new" exit from the stomach was closed
up, so now he was totally dependant on the feeding tube. He had also become
diabetic, so I had to learn how to monitor his blood sugar and give him
insulin shots. I was so scared the first time, but it went well. On Oct.
10th, we were able to bring him home. I couldn't leave him alone and he was
unable to get into our bed (it's too high). I set him up with the feeding
pole and rearranged the house so we could get him to and from the bathroom
and into the living room. I tried to make everything accessible for him. He
was still having bad back pain and getting worse, so I would give him lotion
back rubs several times a day. It would ease him off and let him get some
rest. While he was home, his condition kept going down. He was still not
jaundiced, had never been, but was weaker and more disoriented. Many times
he would not know where he was, or where the door was to the bedroom.
Finally, on Oct. 22nd, after having walked around the back yard with his
oldest son the day before, he couldn't get out of bed and we had to get him
to the ER. They admitted him and said he was dehydrated and his bilirubin
count was too high. At this point, he went on the cancer floor. The pain
was unbelieveable. At first, he was on meds every 6 hours, then 4, then even
4 hours could not control it. The Dr. suggested that we try 5FU plus
radiation to try to "soften" the tumor and control the pain. He
made it through the 4 days of continuous 5FU and the first 5 radiation
treatments before he had to quit. At that time, Nov. 2nd, he said he just
wanted to be kept comfortable and go in God's time. We stopped the tube
feeding that day (his intestines were not working anymore and he needed meds
to have a movement, and even that was not working), and waited until his son
got here from WI before we stopped the hydration. We were told then that it
would be less than a week. He was put on a pain patch at first, but we were
having to increase the strength every day. He was then put on a morphine pump
with bolus shots for breakthrough pain. Even that did not completely cover
and the mg's were upped daily, starting at 5 and by the time he passed away,
it was at 100. He was halucinating, thinking that the TV was telling him
when he was going to die and he did not want me to leave him at any time. I
stayed at the hospital for 18 days/nights. When the agitation became too
much, they would have him Ativan in the IV. This would put him to sleep
almost immediately. For that last 18 days, he was out almost constantly. If
he came around it was only for a few seconds at most and his one look was at
the chair I sat in beside his bed. If he saw me, he would close his eyes and
drift back off. He died Nov. 20th, one minute after midnight. The last 24
hours before his death, his breathing changed dramatically. Where he had
been taking 14 to 16 breaths a minute, they increased to 40; his blood
pressure went up, his fever was over 103 and would not come down, until 4 pm
on the 19th. He suddenly exhaled loudly, and began breathing softer, slower,
and his blood pressure dropped. By 8 pm it was 56/39 and at 11:30 it was
27/19. When he passed away, it was simply one second he was taking a breath,
then he didn't. He weighed 165 when diagnosed with this disease, he was no
more than 100 lbs when he died. His tumor at the first CT scan was 7.5 cm;
when he died it was 7.5 x 10.5 x 9cm and was described by the Dr as the size
of a large oval grapefruit. It was pressing on the spine and all major
organs.

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